Bargaining is due to get underway next week between the New Zealand Nurses Organisation (NZNO) and representatives of the about 530 general practices and medical centres covered by the NZNO Primary Health Care MECA (multi-employer collective agreement)

Chris Wilson, the NZNO industrial advisor for Primary Health, said a major focus of the talks will be pay parity with the recently settled DHB MECA but it was also seeking coverage and appropriate pay scales for registered nurse prescribers and nurse practitioners (NPs).

A new regulation introducing RN prescribing in primary health and specialty teams came into force in September 2016* and the numbers have grown from 80 this time last year to nearly 210. To become an RN prescriber, a nurse has to complete a Nursing Council-approved postgraduate diploma in registered nurse prescribing for long-term and common conditions or equivalent.

“We are looking to have additional recognition for RN prescribers because this is an extended scope of practice and needs to be valued accordingly,” said Wilson. It was also wanting to discuss coverage of senior nurse pay scales in the PHC MECA, including nurse practitioners with Nursing Council statistics for 2016 indicating that 30 per cent of NPs practised in primary health care.

But a major focus of the talks would be the now 6 per cent pay gap between PHC and DHB nurses following the recent DHB NZNO pay settlement and the need to retain pay parity by also adding additional pay steps to the current PHC five-step pay scale to keep it in line with the DHB nurses new basic pay scale. The top of the current pay PHC pay scale is $32.44 an hour ($66,851 a year) and the new MECA would have to introduce a new step 7 of $37.10 an hour by May 2020 to retain parity with the new top step of the DHB basic pay scale (about $77,000 a year).

Asked whether she was concerned that practice and other primary health care nurses would seek jobs in the higher paid DHB sector – which won extra funding of $38m to take on the equivalent of 500 extra nurses to meet immediate safe staffing concerns – she said there was a “high level” of interest from members over how the upcoming negotiations went.

“From our perspective we are definitely looking to how we can shrink that gap,” said Wilson.

“It is so important in terms of recruitment and retention for primary health care.We want to retain a quality and effective workforce as PHC is a specialty. Nurses like to choose that specialty but if there is a significant pay difference – and we know there currently is – then that is going to be a major issues for medical centres and general practices in terms of being able to retain and also recruit.”

The New Zealand Medical Association (NZMA), which will represents the majority of practices covered by the MECA in the negotiations, said it would not comment while negotiations were underway.

At last month’s NZMA-supported South General Practice Conference, the Health Minister Dr David Clark was questioned from the floor about the ‘significant cost’ to primary care of practices having to match the recent DHB nurses’ pay increase.

Clark said he accepted that workforce costs were going up for the sector and the challenge was real.

He added that he had received Ministry of Health advice that the Labour Cost Index (which reflects movements in salary and wage rates and is used to fee into the funding formula for primary health care) had jumped significantly because of the pay equity settlement so primary care “has been getting the funding in advance of the cost increases coming”. He told the gathering that he was “not intending to stop that … you guys face plenty of pressures”.

Wilson said it was aware of Clark’s comments and was seeking to find out more about current funding levels.

*There are now more than 300 nurse practitioner prescribers (the top level and only autonomous nurse prescribers), and a group of nurses has been trialling a third and more limited level of RN prescribing in community health. 


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